Bladder Cancer Clinical Manifestations: -starts at the base of bladder @ ureteral orifices and bladder neck -visible painless

hematuria -UTI (freq. & urgency) -Pelvic or back pain may indicate metastasis Etiology:

Risk Factors: -smoking -Chronic or recurring UTI -high urine pH -pelvic radiation Diagnostics: -*cystoscopy -CT -fresh urine or saline irrigated urine (tells prognosis and staging)\ -Biopsies & adjacent mucosa (definitive test) -ultrasonography -excretory urography -bimanual exam Surgical Management: -transurethral resection or fulguration (cath) (eradicates tumors through surg. Incision or elect. current) -bacille Calmette-Guerin (BCG) (Live stream of mycobacterium buris administered intravesical) -high cholesterol intake -bladder stones -surrounding cancers that spread

-(For invasive cancers) Radical Cystectomy: MEN RC- removal of bladder, prostate, seminal vesicles WOMEN RC- removal of bladder, lower ureter, uterus, fallopian tubes, ovaries, anterior vagina, & urethra *May include the removal of the pelvic lymph nodes. *BCG therp. Most effective for recurrent cancer and can boost immunity.